Department of Pediatrics, Faculty of Medicine, University of Yamanashi, Japan.
Seizure. 2012 Sep;21(7):496-500. doi: 10.1016/j.seizure.2012.05.001. Epub 2012 Jun 12.
Excessive weight gain associated with valproate sodium (VPA) may predispose patients with epilepsy to other health problems such as insulin resistance. The purpose of this study was to examine the changes in body weight and several biochemical parameters in children receiving VPA treatment. The effects of behavior therapy for epileptic children with VPA-induced weight gain are discussed.
Fifteen patients newly diagnosed with epilepsy were included in the study. The following parameters were measured: body weight, body mass index (BMI), serum glucose, serum insulin, serum VPA concentration and serum free carnitine. In addition, behavior therapy was introduced at the initiation of VPA therapy, and lasted at least for 2 years.
After 6 months of follow-up, there were eight (53%) patients in whom weight gain was demonstrated. Significant increases in the serum insulin level and the insulin/glucose ratio were observed in the weight gain group (p<0.01). All patients with significant weight gain showed increased appetite. However, BMI stopped increasing with intensive behavior therapy.
These findings suggest that an increase in serum insulin and insulin/glucose levels may cause weight gain, possibly by stimulating appetite, and that weight changes seem to be reversible with intensive behavior therapy without discontinuation of VPA.
与丙戊酸钠（VPA）相关的体重过度增加可能使癫痫患者易患其他健康问题，如胰岛素抵抗。本研究旨在研究接受 VPA 治疗的儿童的体重和几项生化参数的变化。讨论了针对 VPA 诱导体重增加的癫痫儿童进行行为治疗的效果。
本研究纳入了 15 名新诊断为癫痫的患者。测量了以下参数：体重、体重指数（BMI）、血糖、胰岛素、血清 VPA 浓度和血清游离肉碱。此外，在开始 VPA 治疗时引入了行为治疗，至少持续 2 年。
随访 6 个月后，有 8 名（53%）患者出现体重增加。体重增加组的血清胰岛素水平和胰岛素/血糖比值显著升高（p<0.01）。所有体重显著增加的患者均表现出食欲增加。然而，通过强化行为治疗，BMI 停止增加。
这些发现表明，血清胰岛素和胰岛素/血糖水平的升高可能导致体重增加，可能是通过刺激食欲引起的，并且通过强化行为治疗而不停止 VPA 治疗，体重变化似乎是可逆的。
